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Author Topic: Are these side effects???  (Read 2446 times)

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Offline tucker

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  • Posts: 35
Are these side effects???
« on: September 17, 2009, 07:58:59 PM »
Hey!  I have been on Truvada, Reyetaz, and Norvir for the past year with good results... However, I have had several friends remark that I would look healthy if the whites of my eyes weren't tinged yellow.  I thought it was just in my head... but now I am thinking it might be from my medication?  Also, no matter how much dieting I do, I have a pot belly that will not go away.  I was always pretty trim, but now am saddled with yellow eyes and a gut.  I tried running for several weeks, but my knees hurt so bad I had to stop completely.  I was a runner in my teens and 20's, and never ever had any problems with my knees.  So... my question is, are these things side effects of my medication, or are they from just having HIV in general, or are they because I am in my 30's and getting older???  It is frustrating, and the vibe I am getting from my doctor is that these are mild concerns and don't warrant switching medication I am 'doing well' on.  I have the k103 mutation, so my options are limited, and I can understand not switching my meds... but it would be really nice to not have yellow eyes and a pot belly and knees that can stand jogging 3 miles a couple days a weekl.  I feel like I am 60, not 32.  Help.  Thanks in advance to anyone who offers some assistance. 
confirmed diagnosis 10.1.07
10/07  cd4 504 vl 40,000
1/08  cd4 524 vl 73,000
4/08  cd4 484 vl 48,060
6/02/08 started Truvada, Reyetaz, Norvir
7/08 cd4 605! vl 400
9/08 cd4 713 vl 175

k103 mutation :(

Offline Inchlingblue

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Re: Are these side effects???
« Reply #1 on: September 18, 2009, 01:50:58 AM »
The yellow eyes are a side effect of Reyataz and in many people it goes away but I guess in your case it hasn't. I know of someone who said that they were able to minimize it by drinking lots of water, I'm not sure if that would work but it's worth a try.

If the fat is the kind you can grab on to, it might be a regular pot belly but if it's harder to grab then it might be what's called visceral fat, which means it's between the organs in an area deeper inside than regular fat. Visceral fat is likely a side effect of HIV meds (likely the PIs, but not necessarily), part of what's called lipodystrophy. It's not that easy to get rid of but it may be possible to make it better, not as prominent. Exercise is very important, but not only cardio such as running but also strength/resistance with either free weights or machines. If you can't run because of your knee there are machines at many gyms (if you can afford a membership) that have low impact on the knees and give you a great cardio/aerobic workout. You can also try bike riding, either stationary or a regular bike outdoors. I would recommend a workout that is 80% resistance/strength training and 20% cardio/aerobic.

There are medications being studied to see if they can help with lipodystrophy such as Tesamorelin and Serostim and even Metformin, which is for diabetics. The jury is still out on all of these but they show promise.

You should check your testosterone levels because low testosterone can maybe be part of the problem.

You should also try the so-called "Mediterranean diet" which is considered very "lipid-friendly.''

While it's not inevitable to get a lipo gut (look at that guy from Project Runway, Jack Mackenroth, he's been poz since the early 90s and has six pack abs, go figure), the fact is that a great majority of men with HIV have one (I think with women fat distribution presents differently but they also get a gut sometimes). There are ways, mentioned above, which can make it better.

Lastly, there's no reason why a switch in meds should be out of the question. You might consider switching Reyataz with something else that is not a PI, such as Isentress. You can always go back to Reyataz in the future if you ever wanted to.

There are no guarantees with Isentress either, in fact it's newer so who knows, but the fact is that it is very lipid-friendly as far as cholesterol, etc so that could indicate that it's also less likely to cause lipodystrophy.

QUESTION: Did you notice the "pot belly" start after starting meds? If so, about how long after?
« Last Edit: September 18, 2009, 02:02:37 AM by Inchlingblue »

Offline Tempeboy

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  • Posts: 356
  • Like St Francis of Assisi I am wedded to Poverty
Re: Are these side effects???
« Reply #2 on: September 19, 2009, 12:16:12 PM »
Hey Tucker,

The yellowing of the eyes is commonly associated with Reyataz and will resolve if you should choose to stop taking the drug - of course you would need to discuss this with your doctor.

The accumulation of belly fat is commonly associated with all Protease Inhibitors (Reyataz and Ritonavir) and will improve if not fully resolve when the drug is ceased.  Again this would be something that you would need to discuss with your doctor.  Reyataz has recently been demonstrated to be one of the drugs more associated with cardiovascular disease - especially in the long term - as is Kaletra.

There are so many choices now with medications that it is often possible to taylor a combination that will minimise side effects.  There are available to you Darunavir (a PI less associated with belly fat) Isentress, the NNRTI's (most recently Intelence) and Maraviroc - just to name a few.  None of these seem to cause yellowing of the eyes or lipodystrophy.

All the best and let us know how you go.
Roughly roundabout somewhere in the eighteenth or nineteenth century, Sodomite begat Homosexual out of moral, medical and legal models, bequeathing him Identity, who inbred with Nuclear Family and Industrialism to spawn Homophobia.

Dean Kiley

Offline tucker

  • Member
  • Posts: 35
Re: Are these side effects???
« Reply #3 on: September 21, 2009, 04:30:37 PM »
Thank you so much guys.  That was a wealth of information, and I feel I will be well-armed with information when I go back to the docs in early November.  I wasn't sure that I had options as far as meds go, given the mutation.  It seems like reyetaz is the culprit of my yellow eyes AND the gut... I hope my doctor won't give me a hard time about switching to something else.  Really appreciate your help!  ;)
confirmed diagnosis 10.1.07
10/07  cd4 504 vl 40,000
1/08  cd4 524 vl 73,000
4/08  cd4 484 vl 48,060
6/02/08 started Truvada, Reyetaz, Norvir
7/08 cd4 605! vl 400
9/08 cd4 713 vl 175

k103 mutation :(

Offline tucker

  • Member
  • Posts: 35
Re: Are these side effects???
« Reply #4 on: September 21, 2009, 04:33:07 PM »
PS  I noticed the belly within 6 months of starting meds.  I also started zoloft at the same time, so thought maybe that was the problem.  I have been off zoloft for 4 months, and have also lost 15 lbs, but with a lot of effort.  Still have a stubborn 15 to go to be back at my pre-meds weight, which was a healthy 145 for my 5'8'' height.  Thanks again...
confirmed diagnosis 10.1.07
10/07  cd4 504 vl 40,000
1/08  cd4 524 vl 73,000
4/08  cd4 484 vl 48,060
6/02/08 started Truvada, Reyetaz, Norvir
7/08 cd4 605! vl 400
9/08 cd4 713 vl 175

k103 mutation :(

Offline Inchlingblue

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  • Posts: 3,119
  • Chad Ochocinco PETA Ad
Re: Are these side effects???
« Reply #5 on: September 21, 2009, 05:39:33 PM »
 It seems like reyetaz is the culprit of my yellow eyes AND the gut... I hope my doctor won't give me a hard time about switching to something else.  Really appreciate your help!  ;)

Reyataz and PIs in general are not the only culprits when it comes to the pot belly or lipo gut. I know people who have gotten big guts with PI-sparing regimens. In fact, someone on these forums recently posted that they noticed they started to get a gut after a few months on Atripla (I can't find the post or I would include the link here).

Having said that, there are ways to help minimize it with the right diet and the right exercise.

As far as the mutation, I'm pretty sure there are two K103s: K103n and K103v. These might limit your choices somewhat (I think K103n confers efavirenz resistance?) but that does not mean you can't still find an alternative.

That's why Isentress is so attractive, apart from it's excellent side effect profile, since it's a new drug from a new class, it's one that will still work. And if you switch while undetectable, IOW, not because of treatment failure, then you can go back to Reyataz if you ever needed to in the future.
« Last Edit: September 21, 2009, 05:50:08 PM by Inchlingblue »

Offline risred1

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  • Posts: 419
  • My Source for Supps - www.newyorkbuyersclub.org
Re: Are these side effects???
« Reply #6 on: September 23, 2009, 08:36:16 AM »
Hi,

Liver enzyme test will confirm that your yellow eyes are in fact from excess bilibrium.

As we have seen with other posts, making assumptions about what causes what, while it would seem to make perfect sense, isn't always the right way to diagnose your yellowing eyes.

As to running....

I also used to run,,, but now at 50, I'll ride a bike... :)

And Walking is nothing to be sneezed at.

The point is, excess fat is excess fat. Is it the reyataz which is often viewed as less fat impacting than other PI's? That certainly can be the case. My view is that for certain, the meds can or may have a role to play, but not everything we experience can always be a results of the meds.

Our awareness of ourselves certainly increases after we start treatment. So things that may just be a result of our everyday habits and/or aging, may become more apparent to ourselves when in this heightened awareness of our bodies.

I'm no different in that regard. But I try to do what i can do.

For example, one set of good news I found in my last test, other than the results of the meds suppressing the virus and my CD4 recovering, is that my total cholesterol  was 160.... down 45 points. I was rather surprised at this,,, and immediately thought the meds had a hand in this.... but then I realized, that when i started this program, my morning routine also included Psyllium Fiber drink and Yogurt. Like oatmeal, psyllium fiber can reduce serum cholesterol.

So is it the Meds? Diet? Fiber? Yogurt?

Well, when you change more than one thing, its impossible to know for sure. All I know is that my cholesterol is down.

Finding ways to manage our issues so that we can live a better life is the objective. Not always easy, and we do often have to accept something less than we wanted for ourselves. That doesn't mean we need to throw in the towel and surrender.... I just believe that dealing with our mortality issues and body changes comes with the territory. This is not to mitigate the serious issues that some of us have to deal with, or that any issues we are experiencing is "valid". This is not a suck it up speech. Just a perspective I have of my body changes and effects of HIV, MEDS and Aging.

risred1 - hiv +
02/07 CD4 404 - 27% - VL 15k
10/07 CD4 484 - 31% - VL 45k
05/08 CD4 414 - 26% - VL 70k
01/09 CD4 365 - 23% - VL 65k
05/09 CD4 291 - 23% - VL 115k - Started Meds - Reyataz/Truvada
06/09 CD4 394 - ?% - VL 1200 - Boosted Reyataz with Norvir and Truvada
07/09 CD4 441 - ?% - VL 118 - Boosted Reyataz with Norvir and Truvada
09/09 CD4 375 - ?% - VL Undetectable - Boosted Reyataz with Norvir and Truvada
12/09 CD4 595 - ?% - VL Undetectable - VIT D 34 - Reyataz/Truvada/Norvir

Offline Inchlingblue

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  • Posts: 3,119
  • Chad Ochocinco PETA Ad
Re: Are these side effects???
« Reply #7 on: September 23, 2009, 10:49:50 AM »

Liver enzyme test will confirm that your yellow eyes are in fact from excess bilibrium.

As we have seen with other posts, making assumptions about what causes what, while it would seem to make perfect sense, isn't always the right way to diagnose your yellowing eyes.


Your point is well taken as a general rule but yellowing eyes is a very common side effect of Reyataz so if someone is taking Reyataz and has yellowing eyes then it's safe to assume it's the Reyataz, especially if it started after starting the medication.

I don't think bilirubun is an enzyme so when you say "liver enzyme test" this is not where to look. There is a separate reading for bilirubin levels, which is done as part of a regular liver panel on blood tests and if taking Reyataz it is likely to be elevated.

from aidsmeds.com:

Reyataz can increase levels of bilirubin, a pigment found in the liver. Increased bilirubin can cause the skin, nails, and the whites of the eyes to appear yellowish-brown. Increased bilirubin can also be a sign of liver damage. However, in people who have taken Reyataz in clinical trials, an increase in bilirubin has not been associated with any other signs of liver damage.

LINK:

http://www.aidsmeds.com/archive/Reyataz_1563.shtml

Offline risred1

  • Member
  • Posts: 419
  • My Source for Supps - www.newyorkbuyersclub.org
Re: Are these side effects???
« Reply #8 on: September 24, 2009, 01:45:53 PM »
I agree...

But as we have seen, what is thought is a result of a Side Effect, may in fact be indicating something else.

Just recently, someone with severe diarrhea was found to have a serious bowel condition.

That's why I've changed my tune about making assumptions about what causes what. while I consider it likely, best to consult with your doctor and get tested, as you stated, a liver panel test, which I'm sure the doctor will order.

If it is excess bilibrium, i would ask if one drinks a bit, as this seems to make yellowing worse in some folks. But other than that, I have no other knowledge how to manage this side effect, if its is excess bilibrium from the meds.
risred1 - hiv +
02/07 CD4 404 - 27% - VL 15k
10/07 CD4 484 - 31% - VL 45k
05/08 CD4 414 - 26% - VL 70k
01/09 CD4 365 - 23% - VL 65k
05/09 CD4 291 - 23% - VL 115k - Started Meds - Reyataz/Truvada
06/09 CD4 394 - ?% - VL 1200 - Boosted Reyataz with Norvir and Truvada
07/09 CD4 441 - ?% - VL 118 - Boosted Reyataz with Norvir and Truvada
09/09 CD4 375 - ?% - VL Undetectable - Boosted Reyataz with Norvir and Truvada
12/09 CD4 595 - ?% - VL Undetectable - VIT D 34 - Reyataz/Truvada/Norvir

 


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